Toxemia of pregnancy (pre-eclampsia): diagnosis, treatment and prevention (2023)

Pregnancy poisoning is also known as preeclampsia. It is a condition that affects pregnant women, especially in the last 10 to 12 weeks of pregnancy. However, it can affect women from the 20th week of pregnancy and after childbirth.

Preeclampsia is a condition associated with pregnancy. It is caused by high blood pressure, which leads to multiple organ involvement, mainly affecting the kidneys.

The three cardinal symptoms of toxemia of pregnancy are:

  • hypertension
  • proteinuria,
  • Edema.

In fact, hypertension is the causative factor that leads to proteinuria. Loss of blood proteins leads to accumulation of extracellular fluid, which manifests as edema. The edema can best be observed on the dependent body parts such as the legs and hands.

It can be mild or severe and usually occurs later in pregnancy but can also start early in pregnancy. It can be fatal if not treated properly.

Pregnancy poisoning usually goes away after delivery, but some women have symptoms that persist for 4 to 6 weeks. Some women even develop pregnancy poisoning after childbirth.

Prevention and early detection are key to avoiding complications associated with preeclampsia. To diagnose the condition, you need to identify its symptoms early in your pregnancy.

Signs and symptoms of hypoglycemia in newborns, pregnant women and the elderly

Symptoms of pregnancy poisoning:

Symptoms of toxemia of pregnancy can be subtle and variable. Any of the following symptoms may occur in patients with toxemia of pregnancy.

  • Edema in hands and feet
  • protein in the urine
  • High blood pressure, so over 140/90
  • difficulty breathing
  • little or no urination
  • Dor belly
  • Headache
  • nausea
  • to vomit
  • Visual disturbances, i.e. flashes of light etc.

Causes of preeclampsia:

The exact cause of preeclampsia, or toxemia of pregnancy, is unknown. However, it is widely believed to be caused by a malfunctioning placenta. This could be indirectly related to poor diet, excess body fat, reduced blood flow to the placenta, or genetic changes.

Risk Factors for Pregnancy Toxicity:

Certain factors have been identified that increase the risk of preeclampsia. These include:

  • First pregnancy or nulliparity
  • Pregnancy in adolescence or older than 40 years
  • Family history of preeclampsia
  • Getting pregnant from a new partner
  • Having babies that are less than two years apart or more than two years apart
  • obese lady
  • Having a pregnancy with a new partner than having a baby with your previous partner
  • Medical history of diabetes, kidney disease, or arthritis.
Toxemia of pregnancy (pre-eclampsia): diagnosis, treatment and prevention (1)

Complications of preeclampsia:

As discussed above, there can be a lack of adequate blood flow to the placenta, affecting the growth of a fetus, resulting in the birth of a baby that is too small and restricting a fetus' growth.

Therefore, preeclampsia is one of the most common causes of premature birth.

Some of the most common complications caused by toxemia of pregnancy include:

  • Fluid accumulation in the chest.
  • blindness
  • heart failure
  • AVK
  • hepatic hemorrhage
  • Excessive bleeding after childbirth.

When preeclampsia affects the liver or blood cells, it can cause a group of disorders called HELLP syndrome. HELLP syndrome accounts for about 20% of patients with toxemia of pregnancy. HELLP syndrome is a group of 3 conditions:

  • HFOR hemolysis:
    • Hemolysis is a medical term that refers to the breakdown of red blood cells.
  • ISIndicates elevated liver enzymes:
    • Frequently, ALT liver enzymes can be affected. Elevated blood levels of these enzymes can cause a variety of liver problems.
  • LPFor low platelet counts:
    • A low platelet count can delay blood clotting.

This syndrome is a medical emergency that requires immediate attention. If you experience any of the following symptoms, you should see a doctor immediately:

  • Edema in hands and feet
  • blurred vision
  • Bleeding from the nose or gums
  • chest pain
  • Dor belly
  • exertion or tiredness
  • strong headache
  • nausea
  • to vomit
  • stillbirth of a child:
    • One of the most common complications of preeclampsia is stillbirth, which occurs when the placenta separates from the uterus, known as placental abruption, resulting in a reduced supply of nutrients to the fetus.

Diagnosis of preeclampsia:

Toxemia of pregnancy (pre-eclampsia): diagnosis, treatment and prevention (2)

Toxemia of pregnancy is defined asProteinuriamitwo blood pressure measurementsperformed in a previously normotensive woman 4 hours apart above 139/89 mmHgÖtwo systolic blood pressure values ​​above 159 mmHg or diastolic blood pressure above 109 mmHg. In such cases, repeat measurements can be taken after a few minutes to facilitate timely diagnosis and intervention.

The cut-off point for proteinuria is300 mg over 24 hoursby unoW:C (protein/creatinine ratio) of 0.3, or in areas where no protein estimate is available,+1 proteinuria on the dipstick test.

Can a person develop preeclampsia without proteinuria?

Sim. Preeclampsia, or toxaemia of pregnancy, can also be diagnosed in a pregnant woman with new onset high blood pressure and any of the following:

  • New onset thrombocytopenia with a platelet count less than 100,000/ul
  • A creatinine value greater than 1.1 mg/dL or a doubling of serum creatinine with no other apparent cause.
  • Recent abnormal liver function tests (at least twice the upper limit of normal)
  • pulmonary edema
  • Symptoms related to the eyes or the brain.

You can self-diagnose if you have high blood pressure and other symptoms, including:

  • High level of protein in the urine
  • low platelets
  • abnormal kidney functions
  • abnormal liver enzymes
  • fluid in your lungs
  • Severe headache that is not relieved by painkillers.

Laboratory tests to confirm the diagnosis:

  • Blood tests to check platelet counts and kidney or liver chemicals
  • Routine urine analysis for protein
  • Ultrasonic
  • blood clotting factors
  • liver function test

Treatment of toxaemia during pregnancy (pre-eclampsia):

The only definitive treatment for preeclampsia is childbirth. You can visit your doctor regularly to confirm your due date and the right time to give birth. You should also monitor your child's health and the effects of toxemia on their organs.

When your baby is fully developed, usually around 37 weeks gestation, your doctor may suggest delivery or a cesarean section. This will prevent it from getting worse and endangering your life.

Fetal complications of gestational diabetes

If your baby is not fully developed, your doctor will treat your preeclampsia until the baby is developed enough to be safely delivered.

However, if you have mild preeclampsia and are not experiencing severe symptoms, your doctor may recommend the following:

  • antihypertensives (medicines to lower blood pressure)
  • Regular ultrasound for baby's health.
  • Regular monitoring of fetal heart rate with CTG
  • Complete bed rest, mostly lying on left side.

In some cases, if your health is at risk, your doctor may recommend that you stay in the hospital for close monitoring, where you will be given:

  • Antihypertensiva, knows fromHydralazine,Labetalol, INifedipineto lower blood pressure and medication ie Magnesium to control and prevent seizures or other conditions.
  • Steroids to promote better lung development in your unborn child.

If you have severe eclampsia, your doctor may order an immediate delivery to avoid serious complications, even if you are not near your due date.

After the baby is born, it can take up to six weeks for your symptoms to go away. In some cases, they can last much longer.

Diagnosis and screening of gestational diabetes (GDM)

Prevention of preeclampsia:

There is no definitive way to prevent this condition; However, early diagnosis and prevention can save you from dangerous complications. Routine check-ups during pregnancy are highly recommended to prevent pre-eclampsia.

High blood pressure is the most common cause of preeclampsia, and if controlled early, it can prevent preeclampsia and the poor outcomes that come with it. Here are some steps to prevent preeclampsia:

  • Lose some weight if you are overweight
  • stop smoking
  • Regular exercise or walking
  • Try to keep your blood pressure and blood sugar within optimal ranges
  • Accurately monitor and report any major changes in your health.
  • Drink plenty of water daily
  • Minimize salt intake in your diet
  • Avoid fast food
  • Elevate your feet regularly to prevent edema.
  • avoid caffeine
  • Avoid drinking alcohol

If you suffer from chronic high blood pressure or high blood pressure during pregnancy, you should see your doctor regularly. If you need medicines to control your blood pressure, you should take them as directed. If your blood pressure is not optimal despite taking the pills, consult your doctor again. You may need a dose adjustment. or a change in your medication.

Can exercise prevent preeclampsia?

It is best to do the urine test at home. If you develop proteinuria, you should see your doctor right away.

If preeclampsia is not recognized and treated early, it can lead to serious and life-threatening complications such as liver or kidney failure.

Physiotherapy exercises after cesarean section to get back in shape

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